ENROLLMENT FORM/QUESTIONNAIRE

Please fill out this Questionnaire to enroll
in the University. All of the information that we
receive we keep confidential. If at any
time we want or desire to share any information you have submitted, we will be
sure to ask you first for permission.

1. What is your name?

2. What name do you like to go by?

3. What is your age?

4. What is your birthdate?

5. Do you have any children?

6. If you answered yes to question five, how many?

7. What was your conviction?

8. How long have you been incarcerated?

9. What is your projected or most accurate release date, if any? If uncertain or none please state your status.

10. What city do you plan on living in once you are released?

11. What city would you like to live in upon your release?

12. Are you open to the idea of traveling?

13. Would you like to travel?

14. Are you open to the idea of traveling internationally if you were/are not restricted?

15. Would you like to travel internationally if you were/are not restricted?

16. Do you like to write and read?

17. Do you like to draw or have any other artistic interest?

18. What are your hobbies and interest?

19. What skills and trades do you possess?

20. What skills and/or trades would you like to possess?

21. Would you like a job in the areas of your listed hobbies and interest?

22. Would you like a job in the areas of your listed skill or trade?

23. What type or what job would you like to have specifically?

24. Do you mind living and working with others or would you prefer to live and work alone?

25. What’s you most notable characteristic?

26. What’s a quality you most admire in a woman? If you are a woman, what’s a quality you most admire in a man?